Aesop's Future

A quote  from a piece by Edward Hoagland which appeared in the Sunday Review Section of the March 24, 2013 edition of the New York Times.  Entitled "Pity Earth's Creatures" Hoagland bemoans the potential future loss of Aesop's animal metaphors as we, as Hoagland puts it, "shred our habitat."

Mostly that's over......The tortoise and the hare, the lion saved by the mouse, the monkey who would be king, the dog in the manger, the dog and his shadow, the country mouse and the city mouse, the wolf in sheep's clothing, the raven and the crow, the heron and the fish, the peacock and the crane.  From where will we draw replacement similes and language?.........Hogging the spotlight, playing possum, resembling a deer in the headlights, being buffaloed or played like a fish.  Will the clarity of what is said hold?  A "tiger, a "turtle," a "toad."  After the oceans have been vacuumed of protein and people are eating farmed tilapia and caked algae, will Aesop's platform of markers remain?

"Three Cheers for the Bloomberg Ban" - What??

In "Three Cheers for the Nanny State" (NY Times Mar 25) Sarah Conly argues for the Bloomberg Ban on large-size sugary drinks.  The argument is that the general public is just too uninformed or is just not able to fully research the data, or that we, as human beings, all suffer from the bias that bad things just won't happen to us.  In other words, we, as a species, are incapable of making proper, well analyzed decisions affecting our health and welfare.

One has to wonder if we are capable of deciding who to marry, what professions to pursue,  or when to seek medical help etc. - or are these decisions also best left in the hands of a more sophisticated and knowledgable party.    I am certain that such decisions may also affect the general health and welfare.

Though, admittedly, many drinkers of these large-sized sodas will remain quite healthy, Conly proceeds to equate a ban on these drinks to government-imposed bans on excessive highway speed.  After all, she says, many of us are capable of "safe driving" at 90 mph, so why should we "safe drivers" be limited.  It could also be argued that a ban on excessive alcohol intake, or a ban on cell phone use is a similar infringement on individual rights.  After all there are many who can drive very safely with excessive alcohol blood levels, and many who may drive with, perhaps, even greater caution when using a hand-held device.  Those bans are in place for the greater good, so why not ban large sugary drinks?

But there is a great difference between banning acts that affect others and banning activities that affect only the concerned individual.  We do not ban individuals from smoking - only in places where it affects the health of others.   The limitations on drivers clearly affect the health and welfare of those who share their vehicles and their roadways.

Children comprise a separate category.  It is assumed that children cannot be aware of certain dangers and are unable to make appropriate judgements.  The government does have the right as well as the duty to protect them from undue injury in the event that the parents neglect to do so.  Government may ban the sale of cigarettes to children - and even the sale of large-size sugary drinks to children.

But not to an adult.  Unless a large number of purchasers are not just drinking these sodas themselves, but are forcing others to drink them, they should not be banned.

An afternote.  With the ban now in place,  it is the duty of the banning agency to scientifically evaluate the data to determine whether or not this ban has achieved the desired result.  This is not as easy as it sounds.  Controlling variables is such a study will be difficult.

Non-Indicated Medical Diagnostic Procedures - Who Should Pay?

A recent article in the Science Section of the New York Times examined a very prevalent and difficult problem for physicians, namely the right of a patient to "manage" his own diagnostic evaluation, in opposition to the opinions of his physician (Working Together on Costs, February 26.)   The article maintained that patients often "do not want their doctors to take cost into account.............even if those (more expensive) options were only slightly better than the cheaper alternatives."

The issue, unfortunately, frequently results in a physician complying with a patient's request and ordering a potentially expensive diagnostic procedure (e.g. MRI, ultrasound, etc.) even if he feels it is not indicated - "adjusting" the medical record accordingly.  Though, as the article maintains, it is the patient who bears major responsibility for this added cost to medical care, one cannot overlook the physician's complicity.  The doctor often rationalizes that if "I don't order the test, Mr. X will find another physician who will."

Medical insurance should not cover non-indicated procedures.  A patient, however, should not be denied the right to "purchase" a test.   If, in fact, he insists on a non-indicated MRI, he should have the freedom to "buy" one.  Perhaps there could be a new form of insurance policy, priced accordingly, for individuals who are interested in having the option of purchasing such highly-priced, non-indicated diagnostic procedures.

Faith and the Unknown

I find it extraordinary how god-believers use the absence of knowledge as an explanation for the presence of something.  All god arguments are eventually reduced to this principle - since we have no factual explanation, only the existence of a god can be the answer.  It is far more logical to conclude that what is unexplainable today may be explainable tomorrow.  If one uses well-documented history, one must accept this conclusion.  I won't even attempt to argue how far science has already brought us in the understanding of who we are, where we came from, and the universe in which we exist. 

Sure, we do not have all the answers - but what we should really be saying is that "we do not have all the answers yet." One can never logically conclude that the final explanation, for a lack of understanding, is a god - unless, of course, the term god is defined as the repository for what is presently unknown, but may very well be explained at some future time.  It would then follow that this repository is ever-modified, of course, as the knowns and unknowns change.

Faith (or god), some maintain, is necessary to "explain" human emotion and morality.  How else to understand the poetry of a flower, the exhilaration of love, or the human drive to "do the right thing."

Faith can explain nothing.

Faith is believing in something blindly - "blind faith" is a well accepted and, I should add, accurate term.  It is a "fall-back" position.  The fact that science has yet to completely understand the synapses and cells and transmitters and genes involved in certain emotive cerebral processes cannot mean that they do not exist!  In fact, logic demands that one must consider that they do exist and will, one day, be fully understood.  

Historically humans have always used god or faith to explain the unknown.  When we grow to doubt our faith or god-belief, it has been suggested we pay attention to the innocent faith expressed by children - that is how and where our faith may be restored.  Just remember that the vulnerable, innocent child may well believe that the moon is made of cheese.

One cannot logically conclude that what can't be explained is, in fact, explained by faith and god.  There is no answer to what is unknown - that is why it remains unknown!  

Health Care - Lets Face Some Realities

David Goldhill, in an op-ed article in today's NY Times (Feb. 17), has calculated that a 23-year old employee recently hired by his company at a starting salary of $35,000 will, over her lifetime, have borne a cost of $1.8 million in health care costs - assuming no growth beyond current estimates, that she never has a working spouse, and that she and her dependents never contract a serious illness.  (See full article for the details.)  His piece ends with yet another plan to mitigate this circumstance, suggesting that health insurance be limited to "truly rare, major and unpredictable illnesses."  "In other words," he goes on, "let's cover everyone but not everything."

Yet another potentially reasonable solution to a problem that will be ongoing as long as people demand "life at all costs."  If I were to offer you the choice of virtual poverty v. one more year of life, what would your choice be?  If I were to offer you the choice of virtual poverty v. one more year of your child's life, what would your choice be?  If I were to offer you the choice of virtual poverty v. one more year of life for your 80-year-old parent, what would your choice be?  Until we come to some sort of understanding as to what the actual problems are can we truly get a firm grip on a solution.

The marvels of medicine will continue to grow - new technology, new drugs, new techniques, new prostheses, new computer-activated appliances, the blind will see, the deaf will hear, the lame will walk - new hearts, new lungs, new livers, etc.  but at an extraordinary cost!  To provide all services to all people seems an improbable, if not, impossible achievement.  At some point soon we will have to face the reality of the cost of perpetual health and perpetual life.  At some point soon we will have to face the reality that this goal may be economically and societally unsustainable and that some limitation of services will be required.

Employers and Health Insurance Rights

New lawsuits are challenging a government policy under the Affordable Care Act - a policy that requires employers to provide health care coverage that includes birth control.  The law exempts employers whose organizations' purpose is to promote religious values, that primarily employ and serve people who follow their religious views, and who qualify as non-profits under the tax laws.

Private employers who hold strong religious convictions about the immorality of birth control and abortion feel that the government, by requiring them to support birth control coverage, is infringing on their First Amendment rights.  This has, in their eyes, become a separation of church and state issue, and has found its way into our courts.

They do not, however, feel that by refusing to comply with the federal requirements, that they are, in turn, infringing on the rights of employees who do not share their views.  I, assume, under a decision to edit the terms of health insurance, employers may also require documentation that procedures such as tubal ligation, hysterectomies, vasectomies, and orchidectomies (excision of the testes) have a clear medical indication unrelated to birth control.

If an employer were to discover that a salaried employee had actually used this money to purchase birth control devices, should the employee be terminated?  After all the employer is, though indirectly, supporting an act that he feels is morally reprehensible.  Perhaps he should not employ anyone who does not, first, indicate in some manner that he/she will not expend salaries for such objectives.

I know of no taxpayer, individual or corporate, who is allowed to refuse to pay taxes to a government that supports efforts that the payer may find morally reprehensible.  We all have to pay taxes whether we are pacifists or not, whether we believe in abortion, or not, whether we believe in capital punishment or not, whether we believe in charter schools or not, etc.

In refusing to provide the coverage (e.g. the financial wherewithal) for birth control and the like, it is not the employee or the government who is acting immorally, but the employer!

Saving on Gas With Your Prius - Forget It!

In a previous Blog (The "Nanny State," Taxes and Bad Behavior, Aug 2, 2011) I indicated how governments have come to rely on "sin" taxes to support their budgets, suggesting that prostitution and smoking may be "bad behavior" on moral or medical grounds, but profitable for the tax base of certain states.  A significant decrease in these activities will negatively affect revenue.

Now, it seems, that the reduction in fuel taxes resulting from the increased efficiency requirements for automobiles has adversely affected tax revenues, both federal and state.  Taxes on gas use are said to have fallen precipitously.  Not to worry.  Representative Earl Blumenauer of Oregon has suggested that the fuel tax be replaced with a VMT tax - a tax to be based on "vehicle-miles traveled."  Drivers who use roads more should pay more for that use - similar to a toll, I guess, but now all roads would, in effect become toll roads.  The tax would be collected at gas stations; miles being calculated by installed GPS systems which would transfer the data and calculate the appropriate tax at the time of re-fueling.

Pretty creative, don't you think?  When one revenue source begins to dry up because of changes in behavior mitigated by a government, another source of revenue must be devised.

But don't think you can get away with a gas-guzzler now.  VMT rates may be related to vehicle-efficiency with higher taxes for the less-efficient.